Mechanisms of Motor Recovery after subtotal Brain Injury

脑部次全损伤后运动恢复的机制

基本信息

批准号：
8465155
负责人：
ROBERT J MORECRAFT
金额：
$ 32.7万
依托单位：
UNIVERSITY OF SOUTH DAKOTA
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-02-15 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8465155
关键词：
3-Dimensional Adult Affect Anterior Horn Cells Area Arteriovenous malformation Brachial plexus structure Brain Brain Injuries Brain region Categories Cephalic Cerebral Peduncle Cerebral cortex Closed head injuries Coupled Data Digit structure Disease Distal Dorsal Elbow Elements Excision Fingers Frontal Lobe Epilepsy Goals Hand Human Ibotenic Acid Impairment Injury Internal Capsule Intervention Ipsilateral Lateral Lead Lesion Lifting Medial Methods Middle Cerebral Artery Infarction Modeling Modification Monkeys Motion Motor Motor Cortex Motor Neurons Movement Muscle Neurologic Neurons Outcome Parietal Pathway interactions Patients Pattern Penetrating Brain Injury Positioning Attribute Presynaptic Terminals Process Recovery Recovery of Function Rehabilitation therapy Research Role Sensory Shoulder Social Impacts Somatosensory Cortex Specificity Spinal Spinal Cord Stem cells Stroke Synapses Tactile Testing Therapeutic Therapeutic Intervention Time Transcranial magnetic stimulation Traumatic Brain Injury United States Upper Extremity anterior cerebral artery arm clinical practice clinically significant density design economic impact frontal lobe functional disability grasp gray matter improved motor control nerve stem cell nonhuman primate novel therapeutic intervention patient population public health relevance research study response sensory system therapy duration time interval tumor

项目摘要

DESCRIPTION (provided by applicant): Stroke and traumatic brain injury often involve the cerebral cortex and are leading causes of functional disability collectively affecting greater than 2 million people per year in the United States. The negative personal, social and economic impacts of these disorders are staggering. In clinical practice, variable levels of motor recovery are commonly observed and occur following damage of the motor cortex or its descending pathways. Although there appears to be considerable functional plasticity in the adult brain, the mechanisms underlying motor recovery following subtotal brain injury remain poorly understood. Our major goal is to test the hypothesis that a central mechanism of functional recovery of arm movement occurs through reorganization of the corticospinal projection from intact frontal motor areas located ipsilateral to a subtotal brain lesion and that forced use therapy enhances the corticospinal linkage. At clinically significant time intervals and under different durations of forced use therapy, we will test this hypothesis by studying neuroplastic adaptations of the corticospinal projection from the arm area of the supplementary motor cortex (M2) following isolated resection of the ipsilateral arm areas of: a) the primary motor cortex (M1) + the dorsolateral premotor cortex (LPMCd) and; b) M1 + LPMCd + the primary somatosensory cortex (S1). Both of these lesion categories involve part of the motor cortex that is typically involved in the most common form of human stroke, namely middle cerebral artery infarction. Hand recovery will be tracked by analyzing 3-D hand and digit motion during reaching and grasping, force control during grasping and lifting, and bimanual coordination using 3 specialized testing methods. This project will lead to a greater understanding of the role of the frontal motor cortices in the recovery process of arm movement following cortical injury and will determine the effect that short and long-term forced use therapy has on recovery outcome and its accompanying neuroplastic response. This research will also assess whether the integrity of spared corticospinal projections from intact motor areas positioned ipsilateral to a lesion of the cerebral cortex underlie functional restitution of hand movement control and whether long-term reorganization of intact corticospinal terminals accompany the recruitment of parallel cortical motor areas after subtotal brain injury. This information will assist in establishing predictors to identify a large patient population that may recover favorably after brain injury with appropriate therapy. Furthermore, it will assist in guiding creative rehabilitative interventions aimed at enhancing frontal cortical participation in the recovery process.

描述（由申请人提供）：中风和创伤性脑损伤通常涉及大脑皮层，并且是造成功能残疾的主要原因，在美国，每年共同影响200万人。这些疾病的负面个人，社会和经济影响令人震惊。在临床实践中，通常观察到可变水平的运动水平，并在运动皮层或其降途径损坏后发生。尽管成人大脑似乎有相当大的功能可塑性，但小计脑损伤后运动恢复的机制仍然很少了解。我们的主要目的是检验以下假设：手臂运动功能恢复的中心机制是通过从位于脑脑损伤的同侧的完整额叶运动区域重组的皮质脊髓投射而发生的，并且强迫使用治疗可以增强皮质脊髓链接。在临床上显着的时间间隔和在不同强迫使用疗法的不同持续时间内，我们将通过研究从补充运动皮层（M2）的手臂区域的皮质脊髓投射的神经塑性适应来检验这一假设：）主要运动皮层（M1） +背外侧前皮层（LPMCD）和； b）M1 + LPMCD +主要体感皮质（S1）。这两种病变类别都涉及运动皮层的一部分，通常涉及人类中风的最常见形式，即大脑中动脉梗塞。将通过分析3-D手和数字运动在伸出和抓握，抓握和提升过程中的力控制以及使用3种专业测试方法的双人配位来跟踪手部恢复。该项目将使对皮质损伤后额运动皮层在手臂运动中的恢复过程中的作用有更多了解，并确定短期和长期强迫使用治疗对恢复结果及其随附的神经塑性反应的影响。这项研究还将评估不保留的皮质脊髓预测的完整性是否位于同侧的完整运动区域，脑皮质的病变是手动移动控制的功能恢复的基础，以及是否长期重新组织完整的皮质脊髓终端伴随着阶段皮层皮质运动区域的招募小计脑损伤后。这些信息将有助于建立预测因子，以确定大量的患者人群，该患者可能会在适当的治疗后脑损伤后康复。此外，它将有助于指导旨在增强额叶皮质参与恢复过程的创造性康复干预措施。

项目成果

期刊论文数量（18）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Greater Reduction in Contralesional Hand Use After Frontoparietal Than Frontal Motor Cortex Lesions in Macaca mulatta.

DOI：
10.3389/fnsys.2021.592235
发表时间：
2021
期刊：
Frontiers in systems neuroscience
影响因子：
3
作者：
Darling WG;Pizzimenti MA;Rotella DL;Ge J;Stilwell-Morecraft KS;Morecraft RJ
通讯作者：
Morecraft RJ

Functional recovery following motor cortex lesions in non-human primates: experimental implications for human stroke patients.

DOI：
10.1142/s0219635211002737
发表时间：
2011-09
期刊：
Journal of integrative neuroscience
影响因子：
1.8
作者：
Darling WG;Pizzimenti MA;Morecraft RJ
通讯作者：
Morecraft RJ

Frontal and frontoparietal injury differentially affect the ipsilateral corticospinal projection from the nonlesioned hemisphere in monkey (Macaca mulatta).

DOI：
10.1002/cne.23861
发表时间：
2016-02-01
期刊：
The Journal of comparative neurology
影响因子：
0
作者：
Morecraft RJ;Ge J;Stilwell-Morecraft KS;McNeal DW;Hynes SM;Pizzimenti MA;Rotella DL;Darling WG
通讯作者：
Darling WG

New Corticopontine Connections in the Primate Brain: Contralateral Projections From the Arm/Hand Area of the Precentral Motor Region.

DOI：
10.3389/fnana.2018.00068
发表时间：
2018
期刊：
Frontiers in neuroanatomy
影响因子：
2.9
作者：
Morecraft RJ;Ge J;Stilwell-Morecraft KS;Rotella DL;Pizzimenti MA;Darling WG
通讯作者：
Darling WG

Volumetric effects of motor cortex injury on recovery of dexterous movements.

DOI：
10.1016/j.expneurol.2009.07.034
发表时间：
2009-11
期刊：
EXPERIMENTAL NEUROLOGY
影响因子：
5.3
作者：
Darling, Warren G.;Pizzimenti, Marc A.;Rotella, Diane L.;Peterson, Clayton R.;Hynes, Stephanie M.;Ge, Jizhi;Solon, Kathryn;McNeal, David W.;Stilwell-Morecraft, Kimberly S.;Morecraft, Robert J.
通讯作者：
Morecraft, Robert J.